Active NPI
Kevin Emmett Boivin, MT
- Massage Therapist
- Surprise, AZ
National Provider Identifier
1730619131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT-28141
- Practice address
- 14950 W Mountain View Blvd Apt 7205
Surprise, AZ 85374-4722 - Phone
- (219) 688-4179
- NPI assigned
- Jun 18, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA.60745513 | WA | |
| Massage Therapist | 225700000X | MT-28141 | AZ | Primary |
Addresses
Primary practice location
14950 W Mountain View Blvd Apt 7205
Surprise, AZ 85374-4722
Mailing address
14950 W Mountain View Blvd Apt 7205
Surprise, AZ 85374-4722
Phone (219) 688-4179
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972655132 | Other | WA | REGENCE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kboivin@massageforgood.org | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT-28141 | AZ | MD | Massage Therapist |
| MA.60745513 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641254400000",
"number": "1730619131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14950 W MOUNTAIN VIEW BLVD APT 7205",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853744722",
"telephone_number": "219-688-4179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14950 W MOUNTAIN VIEW BLVD APT 7205",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853744722",
"telephone_number": "219-688-4179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOIVIN",
"first_name": "KEVIN",
"middle_name": "EMMETT",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-18",
"last_updated": "2022-01-04",
"certification_date": "2022-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA.60745513",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "AZ",
"license": "MT-28141",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "1972655132",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kboivin@massageforgood.org",
"affiliation": "N",
"endpointDescription": "Massage for Good",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "14950 W Mountain View Blvd Apt 7205",
"city": "Surprise",
"state": "AZ",
"country_code": "US",
"postal_code": "853744722",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.